Monday, 23 May 2011

Newsflash: If The State ‘Pays’ You, It’ll Call The Shots…

Overweight welfare claimants in the US state of Arizona face paying $50 (£31) fines if they don't follow a dietary regime laid down by their doctor. Is that fair?

If they think it’s unfair, there’s a way out, isn’t there?

Now the state of Arizona is proposing a radical idea. It wants to impose a $50 annual fine for overweight Medicaid recipients who don't follow a strict health regime developed with their doctor. Those with children, and people overweight due to a medical condition, would be exempt.

Expect to see a huge rise in unwanted children and bogus medical conditions, then.

Monica Coury, assistant director at Arizona's Medicaid programme, says the aim is to change behaviour using a carrot and stick approach, in the same way that increasing cigarette taxes reduced smoking.

"It's undeniable that there is a link between obesity and the rising cost of healthcare in America, so we can't be afraid to discuss this issue.

"It's reaching a crisis level in the US and we continue to complain about the rising uncontrolled costs of care - and yet we don't drill down and test some of these concepts."

Monica, there’s little point in the ‘carrot and stick’ approach – some of these people wouldn’t know a carrot if you hit them with it!

Details of how the scheme, put forward by Governor Jan Brewer, would be administered have yet to be thrashed out, and would be agreed if the state gets the go-ahead from Congress.

In other words, it’s a soundbite.

Should it ever see the light of day, it’ll probably be applicable to about 5% of the originally-intended target population, if that.

But Arizona Senator Kyrsten Sinema thinks the tax is unfair because people like her diabetic grandmother could be penalised because there is no system to determine when a person is or isn't following a medical regime.

If her grandmother is diabetic, then did she not see the bit about those with medical condition-related weight gain being exempt?

Most Americans would agree it's not fair for healthy people to subsidise unhealthy people, she says, but unhealthy people who work for the state and get state health insurance aren't subject to this proposal.

Well, then, the obvious way to fix this is to make them subject to it, isn’t it?

Have you really thought this through?

"This proposal targets only the working poor and elderly, and includes punishing people like my grandmother who aren't unhealthy but have a medical condition."

A better solution to spiralling Medicaid costs, she says, is to lift more people out of poverty by creating jobs in the state.

One problem, sweetie: the government doesn’t create jobs.

And Obama’s government certainly isn’t creating the climate in which jobs are likely to be abundant.

For once, the Libertarian party had the most sensible statement:

This is just another example of nanny-state social engineering, says Wes Benedict of the Libertarian Party.

"If you want to save the state money, which libertarians do, cut Medicaid across the board, but don't single out overweight people and smokers. I wouldn't be surprised if this programme costs 10 times more to administer than it saves."

Quite. Maybe those are the ‘jobs’ that Kyrsten thinks should be created?

Daft as she sounds, there’s always one just that little bit dafter:

The $50 fine alone might not be enough to change behaviour, says fitness expert Lisa Johnson, but it could help encourage doctors to talk about weight issues with patients.

"A recent Harvard study said 61% don't have time to talk to patients about weight loss, so this could have a more dramatic impact on the way doctors see their patients than on the behaviour itself.

"If your wife is nagging at you, you roll your eyes and eat another chip, but if your doctor says you have to lose 10lbs, then you take it more seriously."

Really?

Most people have to live with their wives; they only see their doctor once a week. You do the math, as I believe you like to say over there…

But will this, as Longrider fears, only be the beginning? Is it a case of 'Today, the welfare recipient, tomorrow, everyone else'..?